title: Serum and cerebrospinal fluid cytokine profile of patients with 2009 pandemic H1N1 influenza virus-associated encephalopathy.
abstract: OBJECTIVE
  Since April 2009, the number of patients with 2009 pandemic H1N1 influenza virus infection has been increasing in Japan just as in the rest of the world. Patients with 2009 pandemic H1N1 influenza-associated encephalopathy (pIE) have also been reported. The common clinical symptoms of this condition are seizures and progressive coma with high-grade fever. We previously reported the possible association between seasonal influenza-associated encephalopathy (sIE) and proinflammatory cytokines. However, the pathogenesis of pIE remains to be elucidated.
  
  
  RESULTS
  In pIE patients with a poor outcome, the serum levels of interleukin (IL)-6, IL-10, and soluble tumor necrosis factor (TNF) receptor (sTNFR1) were significantly higher than those in pIE patients without neurological sequelae. Similarly, the cerebrospinal fluid (CSF) IL-6 levels in pIE patients with a poor outcome were significantly higher than those in pIE patients without neurological sequelae.
  
  
  CONCLUSIONS
  Our results suggest that IL-6, TNF-α, and IL-10 play important roles in pIE, and that the serum levels of IL-6, IL-10, and sTNFR1 and the CSF levels of IL-6 are related to neurological complications.
authors.affiliation: Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan. shunji@yamaguchi-u.ac.jp
authors.forename: Shunji
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsushige
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Inoue
authors.forename: Komei
authors.initials: K
authors.lastname: Shirabe
authors.forename: Reiji
authors.initials: R
authors.lastname: Fukano
authors.forename: Takashi
authors.initials: T
authors.lastname: Ichiyama
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood* / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications* / Q000821:virology; D008297:Male
chemical_list: D016207:Cytokines